Medicaid work requirements · Vermont

Medicaid work requirements in Vermont: who is subject and who loses coverage (2027)

Data snapshot 2026-06-03 · part of These 5 Million People Are About to Lose Their Medicaid — But They Don't Have To

Vermont expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 57,298 of them (15.0% of an expansion pool of 61,252) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.

This model's bottom-up estimate is that 16,488 people in Vermont lose coverage by 2034: 14,769 of them still eligible but lost to paperwork and reporting failures, and 1,719 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.

Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. Vermont scores 74 of 100 on this model's ex parte capability index, a low band; its eligibility system is VHC / ACCESS.

Key figures

Model v2-2026-06-03. "Strict" counts adults whose ACS record shows them subject with no observable exemption; "permissive" allows the broader exemption reading.
MeasureVermont
Expansion stateYes
Subject to the requirement via waiverNo
Expansion pool (adults 19 to 64)61,252
Adults subject, strict definition57,298
Adults subject, permissive definition56,152
Share of expansion pool subject15.0%
Projected coverage loss by 203416,488
Hardship exception statusNo qualifying counties
Early implementerNo
Ex parte capability score (0 to 100)74 (low)

Who is subject in Vermont

Of the 57,297 subject adults, 32% already work 80 or more hours a month and 55% are not working. 26% have a child under 14 at home. Among those not working, 56% report a disability and 10% are caregivers.

ACS PUMS 5-year 2020 to 2024, subject adults only.
CharacteristicShare of subject adults
Age 19-2413%
Age 25-3420%
Age 35-4421%
Age 45-5419%
Age 55-6427%
Not working55%
1 to 19 hours a month1%
20 to 79 hours a month12%
80 or more hours a month (meets the bar)32%
Not working: Disabled56%
Not working: Caregiver10%
Not working: Postpartum1%
Not working: Student3%
Not working: Other30%

Why eligible people lose coverage

Of the 16,488 projected to lose coverage in Vermont, 14,769 meet the requirement or qualify for an exemption but fail to document it. 6,500 of those are working people who cannot prove their hours through data the state can see, and 8,270 qualify for an exemption the state does not detect automatically.

Bottom-up model v8.0-2026-05-30; documentation-failure buckets compound over the 14 six-month renewal cycles through 2034.
GroupProjected to lose coverage
Multiple part-time jobs (aggregation failure)2,154
Self-employed (other)1,575
Variable shifts / on-call work1,085
Full-time students not auto-verified451
Cash-paid construction & trades394
Seasonal: agriculture, hospitality, food service370
Volunteering / job training349
Gig / courier (DoorDash, Uber, Lyft, Instacart)121
Medically frail without auto-match3,650
Caregivers of a disabled adult2,356
Parent caregivers of children ≤13 without auto-match604
SUD treatment not flagged in claims data544
American Indian / Alaska Native (tribal exemption)526
Kinship caregivers (non-parent) of children ≤13318
Other categorical exemptions (foster, AYA cancer, SNAP/TANF)178
Recent incarceration (data-match gap)74
Pregnancy / postpartum data lag20

Can the state renew people automatically?

The ex parte capability index blends the state's observed automatic-renewal rate (82% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. Vermont's composite score is 74 (low band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.

ComponentScore
Composite74
Observed ex parte82
Core capability93
Data sources72
Historical churn50

How subjects overlap across exemption categories

Each subject adult sits in exactly one cell. Categories: Working ≥ qualifying hours / income; Parent caregiver of child ≤13; Medically frail; Full-time student.
CombinationAdultsShare
None of the four21,54337.6%
Working ≥ qualifying hours / income9,89217.3%
Medically frail9,18416.0%
Working ≥ qualifying hours / income + Parent caregiver of child ≤136,10210.7%
Parent caregiver of child ≤134,4537.8%
Full-time student2,5884.5%
Working ≥ qualifying hours / income + Full-time student1,3022.3%
Parent caregiver of child ≤13 + Medically frail8881.6%

Counties in Vermont

Subject adults concentrate: Chittenden County (14,860), Rutland County (5,428), and Washington County (5,286) account for 45% of the state's subject population.

All 14 counties in Vermont with subject adults, sorted by count. County figures are model allocations of the state estimate by ACS tract characteristics.
CountyAdults subjectSubject rateProjected lossPoverty rateWorking-age population
Chittenden County14,86013.8%4,27611.0%107,448
Rutland County5,42815.9%1,56211.0%34,196
Washington County5,28614.9%1,52110.0%35,460
Windsor County5,15115.9%1,4829.0%32,456
Windham County4,44417.2%1,27913.0%25,846
Franklin County3,92513.0%1,13010.0%30,210
Addison County3,60716.3%1,0387.0%22,180
Bennington County3,32416.0%95611.0%20,726
Caledonia County2,70915.5%78012.0%17,460
Orange County2,68815.7%7749.0%17,090
Orleans County2,39315.5%68910.0%15,409
Lamoille County2,16913.8%6249.0%15,769
Grand Isle County74317.1%2147.0%4,358
Essex County57117.4%16413.0%3,281

State brief and methodology

Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.

Sources

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